Vascular inflammation and sleep disordered breathing in a community-based cohort

Hassan A. Chami, Joao Daniel T. Fontes, Ramachandran S. Vasan, John F. Keaney, George T. O'Connor, Martin G. Larson, Emelia J. Benjamin, Daniel J. Gottlieb

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Study Objectives: Sleep disordered breathing is associated with cardiovascular disease. The pathophysiologic mechanisms remain unclear, but enhanced vascular inflammation is implicated. We sought to evaluate the association of sleep disordered breathing with biomarkers of inflammation. Design: Crosssectional, observational. Setting: Community-based. Participants: There were 900 participants from the Framingham Heart Study site of the Sleep Heart Health Study (52% females, mean age 60 y, 23% ethnic minorities). Interventions: None. Measurements: We assessed circulating levels of nine inflammatory biomarkers in relation to polysomnographically-derived apnea-hypopnea index and hypoxemia index (% sleep time with oxyhemoglobin saturation < 90%). Multivariable models were adjusted for demographics, smoking, cardiovascular diseases, diabetes, and other potential confounders, without and with adjustment for body mass index. Results: With multivariable adjustment not including body mass index, the apnea-hypopnea index was associated with C-reactive protein, inter-leukin-6, fibrinogen, intercellular adhesion molecule-1, and P-selectin levels and hypoxemia index was associated with C-reactive protein, interleu-kin-6, and fibrinogen levels. After adjustment for body mass index, only the association of interleukin-6 with sleep disordered breathing remained significant: the adjusted mean serum interleukin-6 level was 2.93, 3.14, 3.34, and 4.62 pg/mL, respectively, in participants with apnea-hypopnea index < 5, 5-14.9, 15-29.9, and ≥ 30 events/h (P = 0.01 for trend) and 2.97, 3.01, 3.35, and 4.85 pg/mL, respectively, in participants with hypoxemia index < 0.5, 0.5-4.9, 5-9.9, and ≥ 10% of sleep time (P = 0.02 for trend). Conclusions: In a community-based sample, sleep disordered breathing is associated with higher levels of interleukin-6, a marker of myocardial infarction risk and mortality. Adiposity may mediate the increased levels of C-reactive protein, fibrinogen, intercellular adhesion molecule-1, and P-selectin observed in sleep disordered breathing.

Original languageEnglish (US)
Pages (from-to)763-768
Number of pages6
JournalSleep
Volume36
Issue number5
DOIs
StatePublished - May 1 2013
Externally publishedYes

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Sleep Apnea Syndromes
Blood Vessels
Inflammation
Apnea
C-Reactive Protein
Fibrinogen
Interleukin-6
Sleep
Body Mass Index
P-Selectin
Intercellular Adhesion Molecule-1
Cardiovascular Diseases
Biomarkers
Social Adjustment
Oxyhemoglobins
Adiposity
Smoking
Myocardial Infarction
Demography
Mortality

Keywords

  • Epidemiology
  • Inflammation
  • Sleep apnea syndromes

ASJC Scopus subject areas

  • Physiology (medical)
  • Clinical Neurology

Cite this

Chami, H. A., Fontes, J. D. T., Vasan, R. S., Keaney, J. F., O'Connor, G. T., Larson, M. G., ... Gottlieb, D. J. (2013). Vascular inflammation and sleep disordered breathing in a community-based cohort. Sleep, 36(5), 763-768. https://doi.org/10.5665/sleep.2644

Vascular inflammation and sleep disordered breathing in a community-based cohort. / Chami, Hassan A.; Fontes, Joao Daniel T.; Vasan, Ramachandran S.; Keaney, John F.; O'Connor, George T.; Larson, Martin G.; Benjamin, Emelia J.; Gottlieb, Daniel J.

In: Sleep, Vol. 36, No. 5, 01.05.2013, p. 763-768.

Research output: Contribution to journalArticle

Chami, HA, Fontes, JDT, Vasan, RS, Keaney, JF, O'Connor, GT, Larson, MG, Benjamin, EJ & Gottlieb, DJ 2013, 'Vascular inflammation and sleep disordered breathing in a community-based cohort', Sleep, vol. 36, no. 5, pp. 763-768. https://doi.org/10.5665/sleep.2644
Chami HA, Fontes JDT, Vasan RS, Keaney JF, O'Connor GT, Larson MG et al. Vascular inflammation and sleep disordered breathing in a community-based cohort. Sleep. 2013 May 1;36(5):763-768. https://doi.org/10.5665/sleep.2644
Chami, Hassan A. ; Fontes, Joao Daniel T. ; Vasan, Ramachandran S. ; Keaney, John F. ; O'Connor, George T. ; Larson, Martin G. ; Benjamin, Emelia J. ; Gottlieb, Daniel J. / Vascular inflammation and sleep disordered breathing in a community-based cohort. In: Sleep. 2013 ; Vol. 36, No. 5. pp. 763-768.
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abstract = "Study Objectives: Sleep disordered breathing is associated with cardiovascular disease. The pathophysiologic mechanisms remain unclear, but enhanced vascular inflammation is implicated. We sought to evaluate the association of sleep disordered breathing with biomarkers of inflammation. Design: Crosssectional, observational. Setting: Community-based. Participants: There were 900 participants from the Framingham Heart Study site of the Sleep Heart Health Study (52{\%} females, mean age 60 y, 23{\%} ethnic minorities). Interventions: None. Measurements: We assessed circulating levels of nine inflammatory biomarkers in relation to polysomnographically-derived apnea-hypopnea index and hypoxemia index ({\%} sleep time with oxyhemoglobin saturation < 90{\%}). Multivariable models were adjusted for demographics, smoking, cardiovascular diseases, diabetes, and other potential confounders, without and with adjustment for body mass index. Results: With multivariable adjustment not including body mass index, the apnea-hypopnea index was associated with C-reactive protein, inter-leukin-6, fibrinogen, intercellular adhesion molecule-1, and P-selectin levels and hypoxemia index was associated with C-reactive protein, interleu-kin-6, and fibrinogen levels. After adjustment for body mass index, only the association of interleukin-6 with sleep disordered breathing remained significant: the adjusted mean serum interleukin-6 level was 2.93, 3.14, 3.34, and 4.62 pg/mL, respectively, in participants with apnea-hypopnea index < 5, 5-14.9, 15-29.9, and ≥ 30 events/h (P = 0.01 for trend) and 2.97, 3.01, 3.35, and 4.85 pg/mL, respectively, in participants with hypoxemia index < 0.5, 0.5-4.9, 5-9.9, and ≥ 10{\%} of sleep time (P = 0.02 for trend). Conclusions: In a community-based sample, sleep disordered breathing is associated with higher levels of interleukin-6, a marker of myocardial infarction risk and mortality. Adiposity may mediate the increased levels of C-reactive protein, fibrinogen, intercellular adhesion molecule-1, and P-selectin observed in sleep disordered breathing.",
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AU - Fontes, Joao Daniel T.

AU - Vasan, Ramachandran S.

AU - Keaney, John F.

AU - O'Connor, George T.

AU - Larson, Martin G.

AU - Benjamin, Emelia J.

AU - Gottlieb, Daniel J.

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N2 - Study Objectives: Sleep disordered breathing is associated with cardiovascular disease. The pathophysiologic mechanisms remain unclear, but enhanced vascular inflammation is implicated. We sought to evaluate the association of sleep disordered breathing with biomarkers of inflammation. Design: Crosssectional, observational. Setting: Community-based. Participants: There were 900 participants from the Framingham Heart Study site of the Sleep Heart Health Study (52% females, mean age 60 y, 23% ethnic minorities). Interventions: None. Measurements: We assessed circulating levels of nine inflammatory biomarkers in relation to polysomnographically-derived apnea-hypopnea index and hypoxemia index (% sleep time with oxyhemoglobin saturation < 90%). Multivariable models were adjusted for demographics, smoking, cardiovascular diseases, diabetes, and other potential confounders, without and with adjustment for body mass index. Results: With multivariable adjustment not including body mass index, the apnea-hypopnea index was associated with C-reactive protein, inter-leukin-6, fibrinogen, intercellular adhesion molecule-1, and P-selectin levels and hypoxemia index was associated with C-reactive protein, interleu-kin-6, and fibrinogen levels. After adjustment for body mass index, only the association of interleukin-6 with sleep disordered breathing remained significant: the adjusted mean serum interleukin-6 level was 2.93, 3.14, 3.34, and 4.62 pg/mL, respectively, in participants with apnea-hypopnea index < 5, 5-14.9, 15-29.9, and ≥ 30 events/h (P = 0.01 for trend) and 2.97, 3.01, 3.35, and 4.85 pg/mL, respectively, in participants with hypoxemia index < 0.5, 0.5-4.9, 5-9.9, and ≥ 10% of sleep time (P = 0.02 for trend). Conclusions: In a community-based sample, sleep disordered breathing is associated with higher levels of interleukin-6, a marker of myocardial infarction risk and mortality. Adiposity may mediate the increased levels of C-reactive protein, fibrinogen, intercellular adhesion molecule-1, and P-selectin observed in sleep disordered breathing.

AB - Study Objectives: Sleep disordered breathing is associated with cardiovascular disease. The pathophysiologic mechanisms remain unclear, but enhanced vascular inflammation is implicated. We sought to evaluate the association of sleep disordered breathing with biomarkers of inflammation. Design: Crosssectional, observational. Setting: Community-based. Participants: There were 900 participants from the Framingham Heart Study site of the Sleep Heart Health Study (52% females, mean age 60 y, 23% ethnic minorities). Interventions: None. Measurements: We assessed circulating levels of nine inflammatory biomarkers in relation to polysomnographically-derived apnea-hypopnea index and hypoxemia index (% sleep time with oxyhemoglobin saturation < 90%). Multivariable models were adjusted for demographics, smoking, cardiovascular diseases, diabetes, and other potential confounders, without and with adjustment for body mass index. Results: With multivariable adjustment not including body mass index, the apnea-hypopnea index was associated with C-reactive protein, inter-leukin-6, fibrinogen, intercellular adhesion molecule-1, and P-selectin levels and hypoxemia index was associated with C-reactive protein, interleu-kin-6, and fibrinogen levels. After adjustment for body mass index, only the association of interleukin-6 with sleep disordered breathing remained significant: the adjusted mean serum interleukin-6 level was 2.93, 3.14, 3.34, and 4.62 pg/mL, respectively, in participants with apnea-hypopnea index < 5, 5-14.9, 15-29.9, and ≥ 30 events/h (P = 0.01 for trend) and 2.97, 3.01, 3.35, and 4.85 pg/mL, respectively, in participants with hypoxemia index < 0.5, 0.5-4.9, 5-9.9, and ≥ 10% of sleep time (P = 0.02 for trend). Conclusions: In a community-based sample, sleep disordered breathing is associated with higher levels of interleukin-6, a marker of myocardial infarction risk and mortality. Adiposity may mediate the increased levels of C-reactive protein, fibrinogen, intercellular adhesion molecule-1, and P-selectin observed in sleep disordered breathing.

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